Custom Joint Replacement

With traditional joint replacement, surgeons select an implant from a limited range of sizes. These implants are approximations of the joint and surgeons must shave down a portion of the patient’s actual bone during the replacement procedure to make the implant fit.

With custom joint replacement, surgeons use 3-D printing technology to create custom joints and custom cutting blocks that are sized for the patient. Use of this custom instrumentation greatly reduces the time spent in surgery, by eliminating the traditional step of “matching” the patient’s knee anatomy to the available implant sizes and the cutting of the patient’s bone to accommodate the knee implant.

Benefits:

More optimal fit of the implant

Reduced trauma to the hip or knee by allowing precise removal of damaged bone and preservation of more healthy bone with a more accurate fit, the hope is that the implant will last longer by not wearing out as quickly

Some patients have reported quicker and less painful recovery times

Custom Hip Replacement Story

Wanda Shelling’s hip pain built for years. As her cartilage wore down, her mobility suffered. Over time, she couldn’t stand up straight, bend over to pick things up, or even put socks on. But after a 50-minute procedure, she was up walking in just 7 hours. “For the first time in years, I could stand up straight and walk with normal gait,” she says.

On November 28, 2018, Dr. Donald Hohman performed our region’s first ever custom hip replacement surgery at Texas Health Center for Diagnostics & Surgery, Plano. Rather than choosing the prosthetic from a variety of pre-made sizes, improved imaging has allowed prosthetic manufacturers to make a hip joint that is made just for the patients without cost increases. Just as a tailored suit or dress fits better than one off the rack, these custom joints fit better and avoid risk.

In traditional hip replacements, surgeons keep a variety of sizes at the ready once the patient is opened up, choosing the best fit from mass-produced prosthetics. Hips need replacing when the cartilage at the end of the femur is worn down, causing increasing pain for those who suffer it. If untreated, it can be debilitating. The surgery can be complicated, and if a person has unusual anatomy, the replacement hips may not be the right fit. The pre-made hips can often result in small changes in leg length, pinching, internal bleeding, and changing the way patients walk.

In traditional hip replacements, surgeons keep a variety of sizes at the ready once the patient is opened up, choosing the best fit from mass-produced prosthetics. Now, high-definition 3D scans measure the joint, and the images are sent to Conformis, who manufacturers the titanium custom hip replacements. Hohman, who is part of Texas Orthopedic Associates, is in an early release group of surgeons who are able to test new technologies, and received training on how to perform the custom hip replacement surgery. “The future of joint replacement is going to involve more and more of these these technological advances,” Hohman says. “It better accommodates their unique anatomy.”

The surgery includes a 3D printed guide for where to make the cuts and how to position the joint and socket. Because surgeons don’t have to make any choices about which joint to use once the patient is opened up, the surgery is much quicker and reduces chance of infection, cutting surgery time in half. And for the contracts at the center, Hohman says the surgery won’t be any more expensive than a normal hip replacement.

In two conversations on either side of physical therapy appointments in early December, Wanda Shelling was effusive in her praise of the procedure. “I have been amazed, absolutely amazed,” she says. When Schelling, 63, heard about the new surgery, she was all in. “I saw how customized it was to your body, and it made more sense than what I call the off-the-shelf models,” she says. She did the 3D scan, waited eight weeks, and the prosthetic was ready. The surgery lasted less than an hour and a week later she was up and walking around without pain for the first time in years. “Every day is like a birthday,” she says. “I couldn’t say anything better.”

She has only need a few of her pain pills, and isn’t even taking Tylenol just a week after the surgery. She looks forward to picking up grandchildren, dressing herself, and doing chores around the house. Because the custom hip is a quicker surgery, shorter recovery , and is the same price as the traditional model Schelling hopes others will follow her lead. “I hope others can enjoy the same relief.”